RT Journal Article SR Electronic T1 Local economy and sickness absence: prospective cohort study JF Journal of Epidemiology and Community Health JO J Epidemiol Community Health FD BMJ Publishing Group Ltd SP 973 OP 978 DO 10.1136/jech.2005.036236 VO 59 IS 11 A1 Marianna Virtanen A1 Mika Kivimäki A1 Marko Elovainio A1 Pekka Virtanen A1 Jussi Vahtera YR 2005 UL http://jech.bmj.com/content/59/11/973.abstract AB Study objective: To investigate the effect of the local economy, as measured by municipal revenue and local unemployment rate, on sickness absence among the employed. Design: A prospective cohort study of 60 160 public sector employees (46 081 women, 14 079 men) with ecological measures of municipal revenue and local unemployment rate 1999–2000 and individual measures of sickness absence at baseline 1999 and at follow up 2000–2001. Results: Among men and women, constantly poor local economy, as shown by low municipal revenue and high unemployment rate, was related to decreased self certified sickness absence rates. Local unemployment rate was a stronger predictor of self certified sickness absence than municipal revenue and the effect was stronger among men than among women. High unemployment rate predicted increased medically certified sickness absence among women. Conclusions: Working in areas of poor local economy is associated with increased long term sickness absence but decreased probability to take a short term sick leave. Unemployment rate may have an effect on the threshold to take a sick leave in relation to minor illnesses even when area deprivation poses health risk to its residents. To prevent adverse health effects of presenteeism, working while ill, and to reduce medically certified sickness absence, potential benefits may be attained by improving economic conditions and re-employment in deprived areas.